Health - Reuters

Study Shows Surge in Psychiatric Drug Use in Kids

By Suzanne Rostler
Yahoo!News

NEW YORK (Reuters Health) -
About 6% of US children are
taking drugs to treat depression, attention
deficit/hyperactivity disorder (ADHD) and a host of other
behavioral and emotional problems, researchers said Monday.

Their study of data on nearly 900,000 individuals younger
than 20 years who were enrolled in an HMO or received Medicaid
revealed a 200% to 300% increase in the use of psychotropic
drugs between 1987 and 1996, with the greatest increase
occurring after 1991.

Alpha-agonists such as clonidine, which is used to treat
behavior problems, saw the greatest increase. Prescriptions for
neuroleptics, antidepressants and "mood stabilizer"
anticonvulsants, which are used to control acting out and
violent behavior in kids, also rose during the study.

In general children on Medicaid, the federal health
insurance program for the poor, were more likely to be
prescribed these drugs than were kids whose families were
enrolled in an HMO, and children on Medicaid receiving the
drugs tended to be younger than their HMO-enrolled
counterparts. For instance, children aged 10-14 years were the
largest users of psychotropic drugs among Medicaid recipients,
compared with children aged 15-19 years in the HMO group.

Males were more likely than females to be prescribed
psychotropic drugs overall, particularly if they received
Medicaid, according to the report in the January issue of the
Archives of Pediatric and Adolescent Medicine.

It is not clear from the study why the use of psychotropic
drugs rose so dramatically among children, or why there are
different patterns of use among children insured through an HMO
and through Medicaid.

In an interview with Reuters Health, Dr. Julie Magno Zito,
the study's lead author, said that changes in diagnosis, access
to medical treatment and a greater awareness of the mental
health treatment needs of youths may explain the results.
Greater visibility of drug promotion may also play a role,
according to Zito, of the University of Maryland, Baltimore.

In an accompanying editorial a doctor from Massachusetts
General Hospital in Boston said that the data may reflect
higher rates of mental illness among Medicaid users, who are
generally less well-off than those who use employer-based
insurance. Alternatively, a greater awareness of psychiatric
disorders and better drugs may have led to more prescriptions,
suggests Dr. Michael S. Jellinek.

However, he notes that usage of many drugs increased in
youngsters despite little research on their effectiveness in
children.

"Given the scale of current psychotropic medication
utilization, we have a responsibility to know what we are doing
and the quality of our efforts," Jellinek writes. "We need to
ask the mirror on the wall this question: Are we prescribing
the right psychotropic medications to the right children using
the right treatment plan?"

The study authors conclude that more research is needed to
update the current report and to examine trends for specific
drugs. A more nationally representative group of children might
also better reflect trends, they suggest.